April 2016

From Your RPC Board

Campfires and s’mores. Paddling around in a canoe looking for that legendary gigantic blue fish with its purple eyes—maybe you’ll catch it and make it cough up the camp counselor’s wallet that it devoured ages ago when it was last seen. Stealing other teams’ flags to gain your team points. Chanting verses of “You Can’t Ride in My Little Red Wagon” and other classic camp songs at the top of your lungs while hiking through the woods. Are you nostalgic for your childhood summer camp days yet?

I never went to summer camp as a child. But last summer, I had the opportunity to serve as a camp counselor for a few camps. Each camp was different, as it served children of different medical conditions. At a camp for children with burn injuries, I admired how older campers mentored younger campers, some who were at camp for their first time. Initially my 7-year-old campers (the youngest of the camp) were shy and I wondered what they were thinking as they stood off to the side and stared at other campers, some with much more extensive and visible burn injuries that required face grafting or limb amputations. As they started their activities and projects for the week though, my campers were soon bouncing around with energy, proudly showing me their arts and crafts projects, comedy sketches or songs and dances they choreographed with older campers. It was clear that they had quickly moved on beyond the superficial impressions of each other’s burn injuries.Later that summer, I spent time at another camp for teenagers with upper limb differences (e.g., symbrachydactyly, radial or ulnar dysplasia, cleft hands). This camp was a much smaller camp with less campers; so campers and counselors got to know each other in a much closer setting. While some activities were similar to those in burn camp, I found my experience to be much more profound at this camp. As the week progressed, campers opened up about many difficulties they’ve faced in their lives—some I could not even imagine dealing with when I was a teenager, in addition to all the other typical challenges that teenagers face. I remember one afternoon when we had a girls’ day in one of the cabins, we had the campers and counselors gather into a circle and gave the campers a chance to open up about any challenges they’d like to share with the group. One camper opened up about how her grandfather kept bothering her to get a prosthetic arm even though the camper did not want one because she was fully functional without one; this made her feel like she would never be good enough for her grandfather. While choking back tears, another girl shared with us about how she recently discovered she was born without a uterus and learned she could never have a baby. Another camper told us about how her older sister included everyone in her immediate family in her wedding party except for her, because she didn’t want others to see her sister with a limb difference. As campers embraced each other, I started to understand that this camp was much more than just summer camp for most of these campers; this really was a second home for them—a place where they genuinely felt they could be themselves and not be judged by their upper limb differences.

I feel privileged to get to work in the specialty of PM&R—a specialty that advocates for those with physical differences, impairments, and disabilities and really prioritizes quality of life and function. On a given day at the hospital, I get to know patients through the recovery process while watching them regain their independence and start to return to normal activities of life—how could you not love our specialty? Gaining the experiences I had at the camps I attended last summer made me appreciate this even more beyond the small glimpse I usually get into my patients’ lives during the short time they spend in inpatient rehabilitation or even shorter clinic visits. It emphasized the importance of staying involved with the community in which our patients live, to truly appreciate the challenges they face on a daily basis even when we consider them “healthy.” It reminded me that there is still so much we need to work on in our society and in advocacy, even after patients are well enough to stop seeing us in clinics.

New York Presbyterian Hospital offers a 1 year ACGME-accredited sports medicine fellowship. Training includes collaboration with many related departments, a sports medicine didactic schedule, pre-participation, training room, and mass-event coverage. The program currently offers 1 spot per year.

Dr. Welbel:What made you decide to pursue a sports medicine fellowship? Any specific rotations during residency?

Dr. Rand: I enjoyed most of my rotations in residency, but there are definitely rotations where you wake up excited to go to work, find yourself researching and reading about topics at length before and after work, and can't get enough of it. There are rotations where you do not just go in early and stay late because it is the right thing to do for patients, or to enhance your knowledge, but simply because you find it fascinating and love it. That's sports medicine for me. I wanted to learn more, further develop my knowledge of musculoskeletal and regenerative medicine, the role of exercise in health and wellbeing, learn how to care for athletes of all ages, and further develop my ultrasound and fluoroscopy skills.

Dr. Welbel:What has been the most rewarding experience during fellowship so far?

Dr. Rand: I have really enjoyed being able to finally dedicate all of my time toward developing an expertise in the area of PM&R that I plan to focus my career. Training can be tricky at times. PM&R is a great field because it really gives you a broad perspective during your training that you can later apply to any specific area you choose to focus on. However, it can be challenging in residency to transition every month or two between different specialties. I often had a sense that as soon I was feeling comfortable with a topic, I would need to transition to another. These transitions and this broad training are so important, and with them as a base, I have really enjoyed building on a foundation of knowledge and developing an expertise in musculoskeletal medicine this year.

Dr. Welbel:What are some words of wisdom for sports medicine fellowship applicants?

Dr. Rand: There are several factors that will help maximize what you get from your fellowship year. The first is mentorship. These individuals often share knowledge and skill sets that inspire us to keep learning more and to continue to strive to be better physicians, educators, and researchers. Occasionally, we are fortunate and also find mentors not only with the knowledge and skills, but also the heart. I feel very fortunate in having that type of mentorship. There will likely be many individuals you can learn from throughout your fellowship year. Exposure to different styles and techniques is invaluable and will allow you to develop your own personal preferences and style. Finally, I have learned the most when I have found opportunities to teach medical students and residents. Find time to meet up with residents and students to go over physical exam maneuvers, journal articles, ultrasound, procedural techniques, etc. I continuously find myself treasuring these moments.

Academy News

National Volunteer Week—April 10-16, Thank You Volunteers!

In celebration of National Volunteer Week, we would like to acknowledge and applaud the hard work and dedication of all Academy volunteers. We wouldn’t be where we are today without your help. You are what ties all Academy resources, services, and events together. Thank you for your commitment!

“What is PM&R?”—Residents and Medical Students Video Competition

As the job of a PM&R physician is to treat a wide variety of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons, lack of understanding about the specialty and its physicians continue to exist.

Your Academy invites medical students and residents to raise awareness for and cultivate an understanding of the PM&R specialty by creating a 2-3 minute video presentation answering the question, “What is PM&R?” Show your #PMRpride and be featured at #AAPMR2016!

The submission deadline is July 31, 2016. We can’t wait to see your creativity! Learn more here.

Fellowship Database is Now Part of the AAPM&R Job Board

NEW! To streamline our career development offerings, we’ve moved the Fellowship Database to the Job Board. The database is a searchable listing of PM&R fellowship opportunities within the U.S., which represents the broad clinical diversity of the PM&R specialty. Visit jobboard.aapmr.org for new fellowship opportunities.

Annual Assembly

Registration Opens Soon for AAPM&R's 2016 Annual Assembly

Have you marked your calendar for the 2016 Annual Assembly? We have so many educational and networking activities planned for you. It will be one of the best Assemblies yet!

Your Academy received more than 800 abstract submissions this year! Thank you to all those who submitted their research and who volunteered their time to assist with reviewing the content. Look for the published abstracts in an upcoming issue of PM&R—the Academy’s scientific journal, and be sure to stop by the Poster Hall in person at the 2016 Annual Assembly, October 20-23 in New Orleans, to see what your peers have been working on.medicine, neurological rehabilitation, and pain management.

Education

Prepare for ABPMR’s Part I Exam by Utilizing AAPM&R Resources

The American Board of Physical Medicine and Rehabilitation (ABPMR) Part I Examination is August 9, 2016. Get a head start on studying with your Academy’s must-have resources, including:

Find all of the above and other great study resources on me.aapmr.org.

Health Policy/Advocacy

Busy with patient care on the wards? Take a minute for this quick update. American health care is changing at lightning speed. Health care’s move toward value-based payment systems is driving much of the changes. Your Academy and the Resident Physician Council are working hard to guide our membership and to protect and promote the future of physiatry.

Please take a few moments from your busy day to get up to speed on the latest developments and news below. The strength of our Academy comes from a strong and well-informed membership. - P. Bobby Katta, DO, JD, LLM and Charles Odonkor, MD, MA

AAPM&R Signs On to Letter to CMS in Response to the Notice of Proposed Rulemaking

AAPM&R, in a collaborative effort with the American Medical Association (AMA), the National Association of Accountable Care Organizations (ACOs) and several other groups, signed on to a letter in late March to the Centers for Medicare & Medicaid Services (CMS) outlining recommendations in response to the agency’s Notice of Proposed Rulemaking that would modify the Medicare Shared Savings Program benchmarking methodology. Learn more.

MedPAC Releases its March Report

The Medicare Payment Advisory Commission (MedPAC) released its March 2016 report, which includes payment policy recommendations for 9 provider sectors in fee-for-service (FFS) Medicare. Learn more.

AAPM&R Supports New Additions to Uniform Glossary of Coverage and Medical Terms

As part of the Coalition to Preserve Rehabilitation (CPR), your Academy signed on to a March letter in support of the new additions to the Uniform Glossary of Coverage and Medical Terms. Learn more.

AAPM&R Participates in the Interagency Committee on Disability Research

The Disability and Rehabilitation Research Coalition (DRRC), which your Academy is a member, was invited to participate in the Interagency Committee on Disability Research (ICDR) convened working groups. Learn more.

AAPM&R Signs On in Support of a Statement of Principles in Medicare Advantage (MA) Plans

As part of the Coalition to Preserve Rehabilitation (CPR), your Academy signed on to a March letter in support of a statement of principles on patient access to rehabilitation services in Medicare Advantage (MA) plans. Learn more.

The Multi-society Pain Workgroup (MPW), representing more than 100,000 physicians and 15 medical societies, including your Academy, applauds the Washington State Health Care Authority’s Health Technology Clinical Committee (HTCC) for preserving access to spinal injection therapies for millions of people who suffer from back pain. Learn more.

AAPM&R's Efforts in the National Pain Strategy, Opioids, ACL Management, and More

On March 18, 2016, the Department of Health and Human Services (HHS) released a National Pain Strategy, outlining the federal government’s first coordinated plan for reducing the burden of chronic pain. Your Academy provided insights to the development of the National Pain Strategy. Learn more.